In the etiology of arrest, which combination of medications should be considered for hyperkalemia?

• A. Ephedrine and Diphenhydramine
• B. Sodium bicarbonate and Calcium chloride
• C. Lidocaine and Amiodarone
• D. Glucose and Insulin

Answer: (B)

In hyperkalemic arrest, the priority is twofold: protect the heart from the high potassium’s effects and actively move potassium into cells. Calcium chloride provides rapid stabilization of the cardiac cell membranes, raising the threshold for excitability and reducing the risk of dangerous rhythms right away. Sodium bicarbonate helps correct acidosis and promotes potassium shift from the extracellular space into cells, lowering the circulating potassium level. Together, this combination both stabilizes the heart and reduces potassium, making it the most effective immediate approach in this scenario. The other options either don’t address potassium reduction, focus only on rhythm control without stabilization, or rely on shifting potassium without providing the crucial membrane-stabilizing effect calcium offers.